[The role of polyclonal anti-T-lymphocyte antibodies (ATG) in the kidney transplantation].

UNLABELLED: The successes in the kidney transplantation are closely connected with the successes of the immunology and the advance of the immunosuppressive therapy. The main task of the modern immunosuppressive therapy is the insurance of medicines with a minimum nephro-toxicity, and the optimum protection regarding the adoptive body against an early reaction of rejection. The polycomponent anti-T-limphocitic antibodies (ATG) give us the opportunity of that. The polycomponent anti-T-limphocitic antibodies or the antilimphocitic serum (ALS) are xenogenetic polycomponent antibodies, that are directed to the human T-limphocites, i.e. antitimocitic globuline (ATG). They are received by immunization of rabbits or horses with human thymus limphoid cells. They are received for the first time by horses, and later on by rabbits. The last patent medicines have more powerful effect. In spite of the side effects of the polycomponent ATG, the patent medicine is used for inductive treatment after transplantation of organs and for a treatment of acutely rejection of the graft. We have treated 15 patients after kidney transplantation with ATG for a period of an year in the ward of kidney transplantation in The Clinic of Urology. The patients with transplantation are at the age of 21 to 50 years old, and by sex--11 male and 4 female patients. 9 of them are transplanted from alive donor and 6--from a dead body. We have applied the patent medicine of ATG Timoglobuline in a phial of 5 mg\ml intravenally in a bank of 500 ml physiological solution according to the weight and the blood test of the patients. We have applied a fourfold immunosuppressive therapy: Urbazon, Imuran, CyA(Neoral) +ATG.

CONCLUSIONS: ATG is a mixture of monocomponent polyspecific antibodies, which, in spite of its side effects, has been applied successfully in transplantation for more than 30 years. In the course of many years anti-CD3 patent medicine OKT3 has been the only one monocomponent antibody for the treatment of an acute rejection of the graft for inductive therapy in transplanted patients.A chimerical (baziliksimab) and humanized (daklizumab) monocomponent antibodies of the alpha-chain of the receptor for IL-2 (CD25) are used for the prophylaxis of the episodes of acutely rejection of the transplanted kidney during the last 10 years. ATG does not consists of anti-CD25 antibodies. That is why the simultaneously application of ATG with baziliksimab or daklizumab is expected to have an additional effect with a complementary mechanism of efficacy.